Lower back pain
Lower back pain
Do you find it difficult to get up in the morning? Does your back or lower back hurt every time you wake up? Does lifting even average weights pose a challenge for you? Do you experience stiffness or sharp pain in lower back area after driving or sitting in front of a computer screen? Has all massage stopped having any effect and would you like to give up on or reduce the use of painkillers?
How to get relief?
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Get rid of the annoying pain!
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More on lower back pain
Pain in the sacroiliac joint – also called lower back pain – refers to pain in joints of the lumbar and hip bone. There can be various causes of these problems, so more examinations are required. Lower back pain can be caused functionally, by degeneration, inflammation, neoplasty within a tumor disease or trauma. The diagnosis is determined by physical, neurological and laboratory-chemical examination, as well as by the X-ray. Therapeutic treatment includes physiotherapy and drugs. However, possible basic disease must be treated as well.
Causes and differential diagnoses
Lower back pain can have various causes. Pain of the sacroiliac joint is often a symptom of some other disease. We distinguish between innate and acquired diseases.
Innate diseases include hereditary ankylosing spondylitis, or Bechterew´s disease. This is a chronic inflammatory disease. Its cause is unknown, yet there is a genetic predisposition and association to HLA-B27, a hereditary tissue antigen that can be determined in blood in 90% of cases. Lower back pain at night is a decisive symptom in the first stage of the disease.
Acquired diseases which include pain of the sacroiliac joint can be conditioned by an inflammation, metabolism or degeneration, or induced by a tumor. Pain occurs by rheumatic diseases, chronic inflammatory bowel diseases like Crohn´s disease as well as by bacterial infections. By bacterial infections we speak about the reactive arthritis. The most frequent causes are urogenital infects caused by chlamydias, gonococcus and ureaplasmas, as well as diarrheal diseases caused by salmonellas, shigellas, yersiniae. Despite the infectious causal agents, this is only a joint inflammation, i.e. there can be no causal agents proved. The inflammation is usually cured within one year.
A chronic disease (Morbus Reiter) develops in one third of the affected. Reiter´s syndrome includes inflammation of urethra, ligament and joint, as well as changes on the skin of the palms and feet, less often with fever and involvement of inner organs.
Lower back pain as a part of a degenerative disease can occur in rather older patients and can be found e.g. by advanced osteoporosis and arthrosis. Arthrosis is a degenerative joint disease that appears when there is a disproportion between the condition of the joint and its loading. Some causes include overweight, heavy work and inflammatory joint diseases. The sacroiliac syndrome results from the blocking of lumbar-hip joints caused by overload, loosening or reflectively by diseases of intervertebral discs.
There is also functional pain that mainly occurs by wrong posture or loading.
The therapy of lower back pain primarily includes physiotherapeutic measures like medicamentous treatment. If there is also pain of the sacroiliac joint as an accompanying sign of other diseases, also treatment of the basic disease should proceed.
An early diagnosing is decisive by Bechterew´s disease. Therapeutically, the physical therapy with strengthening of the back muscles for prevention of the typical deflection and stiffness of the back is the primary prevention against pain.
If lower back pain was conditioned by degeneration, taking calcium, D vitamin or calcitonin in conjunction with physiotherapy is a successful pain treatment – much like with osteoporosis. If the pain is acute, a local injection with preparations against pain, so called local anesthetics, can help and improve mobility.
There are various physiotherapeutic options, from heat application – e.g. mud wraps – through manual therapy to unblock and relax muscles, to the treatment of reflex areas, underwater gymnastics, treatment through short-waves and ultraviolet rays or stimulation current. Physiotherapy should lead to painlessness and renewal of the joint function. It´s also important to lead patients to muscle strengthening and make them avoid the original and wrong posture.
The most important complication of osteoporosis is a fracture, i.e. a broken bone without an injury. Women with post-climacteric osteoporosis often suffer from spinal fractures; with senile osteoporosis in both genders fractures of the femoral bone can occur. Older patients also fall more often due to their cardiovascular diseases, too low blood pressure, slower reactions and less trained muscles than young people. Then we speak about an “unprotected falling”. Patients with osteoporosis often suffer from fractures after such “unprotected falling”.
"What can we do?“
Early diagnosing of lower back pain is very important. If it is pain of the sacroiliac joint conditioned by an inflammation or degeneration, painlessness can be often achieved with the help of physiotherapeutic measures. The patient can do relaxation, relieving or strengthening exercises after being instructed by a trained physiotherapist. Also heat application and water exercise can be done individually. However, it´s important to speak with one´s doctor and be instructed to avoid wrong loading.